Comparative Infection Rates for the Codman BACTISEAL TM External Ventricular Drainage (EVD) System

NCT ID: NCT00197392

Last Updated: 2013-11-05

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

434 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-11-30

Study Completion Date

2010-01-31

Brief Summary

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The purpose of this non-significant risk study is to establish initial baseline infection rates for the Codman BACTISEAL External Ventricular Drainage (B-EVD) System (Antibiotic impregnated catheter) and to compare relative rates of ventriculostomy-related infection between Subjects with BACTISEAL or conventional EVD catheters in a prospective, randomized open label study

Detailed Description

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External ventricular drainage catheters are widely used in the management of Subjects with elevated intra-cranial pressure (ICP) secondary to acute hydrocephalus due to sub-arachnoid hemorrhage, intra-cerebral hemorrhage, intra-ventricular hemorrhage and other causes that obstruct the cerebrospinal fluid (CSF) circulation. However, this mode of treatment could be compromised by the increased risk of catheter related CSF infection.

B-EVD is manufactured using a patented process to impregnate silicone catheters with two antibiotics, rifampin and clindamycin. These antibiotics are impregnated throughout the silicone matrix. After implantation, slow release of both antibiotics at the extra- and intra-luminal catheter surfaces minimizes the likelihood of bacterial colonization. The B-EVD Catheter System has, to date, been well accepted by domestic and European customers. Currently there exists sound scientific rationale and promising bench-top in vitro data to anticipate low levels of ventriculostomy-related infection in Subjects using this system. Published BACTISEAL shunt data and direct feedback from U.S. market experience also support this notion. There are no published clinical studies reporting infection rates with the use of the B-EVD System, making all statements regarding its propensity to minimize clinical risk for catheter-related infection mere speculation and anecdotal. Therefore, Codman proposes to undertake a controlled clinical evaluation of this product to demonstrate its influence on EVD catheter-related infections, using a conventional EVD catheter as a standard of reference.

Immediately following successful screening, the Subject will be randomized to test or control group and will have the appropriate EVD system implanted. The Treatment Phase will cover the duration of the implanted EVD system. Subjects will be monitored for 2 weeks post-explant.

This study is expected to enroll 600 evaluable implanted Subjects at up to 15 Investigational Sites in US, Europe and Asia-Pacific

Conditions

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Intraventricular Hemorrhage Subarachnoid Hemorrhage

Keywords

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Ventriculostomy EVD

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Bactiseal TM EVD

Bactiseal External Ventricular Drainage System.

Group Type EXPERIMENTAL

Bactiseal TM EVD

Intervention Type DEVICE

Standard of care implantation of external ventricular drainage catheter

Standard EVD Catheter

Standard External Ventricular Device system

Group Type ACTIVE_COMPARATOR

Standard EVD Catheter

Intervention Type DEVICE

Standard of care EVD system other than Bactiseal.

Interventions

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Bactiseal TM EVD

Standard of care implantation of external ventricular drainage catheter

Intervention Type DEVICE

Standard EVD Catheter

Standard of care EVD system other than Bactiseal.

Intervention Type DEVICE

Other Intervention Names

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EVD,Bactiseal, standard EVD, ventricular catheters

Eligibility Criteria

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Inclusion Criteria

* The Subject is 18 years or older.
* The Subject (family member/legal representative) has given written Informed Consent prior to enrollment into this trial OR, where the Subject is unable to consent and no relative/legal representative is available to offer consent, appropriate legal and ethical practices are employed and thoroughly documented according to the laws and policies of the respective country and institution.
* The Subject (family member/legal representative) is willing to participate in this trial for the duration of the implanted EVD system and is willing to comply with the protocol requirements.

Exclusion Criteria

* Within the preceding 30 days, the Subject has enrolled or participated in another trial utilizing an anti-microbial drug or medical device implanted in or directly influencing the CNS and/or spinal cord.
* The Subject is pregnant or lactating.
* The Subject has a suspected or documented allergy to the materials of the EVD system, including silicone, rifampin and clindamycin.
* The Subject has a positive CSF culture prior to EVD implant.
* The Subject is immunocompromised.
* The Subject requires more than one ventricular catheter concurrently.
* The Subject has had an EVD catheter within the previous 30 days.
* The Subject has sepsis, ventriculitis, meningitis, a skin infection/inflammation at or near the implantation site, an ear infection on either side, or a severe respiratory tract infection that, in the opinion of the Investigator, would most likely compromise the effectiveness of the EVD system.
* The Subject is known to have received systemic antibiotic therapy within a 14-day period preceding screening for inclusion in this trial.
* The Subject has an uncontrolled coagulopathy or any other known bleeding diathesis.
* The Subject is otherwise determined by the Investigator to be medically unsuitable for participation in this trial.
* The Subject is a prisoner.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Codman & Shurtleff

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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J. Thomas Megerian, MD, PhD

Role: STUDY_DIRECTOR

Unaffilliated

Locations

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Los Angeles, California, United States

Site Status

Gainesville, Florida, United States

Site Status

Syracuse, New York, United States

Site Status

Hershey, Pennsylvania, United States

Site Status

Calgary, Alberta, Canada

Site Status

Edmonton, Alberta, Canada

Site Status

Sherbrooke, Quebec, Canada

Site Status

Tiantan Hospital

Beijing, , China

Site Status

Xuan Wu Hospital

Beijing, , China

Site Status

Angers, , France

Site Status

Lille, , France

Site Status

Paris, , France

Site Status

Prince of Wales Hospital

Hong Kong, , Hong Kong

Site Status

Queen Mary Hospital

Hong Kong, , Hong Kong

Site Status

Oslo, , Norway

Site Status

National Neuroscience Institute

Singapore, , Singapore

Site Status

Singapore General Hospital

Singapore, , Singapore

Site Status

Bristol, , United Kingdom

Site Status

Leeds, , United Kingdom

Site Status

Salford, , United Kingdom

Site Status

Countries

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United States Canada China France Hong Kong Norway Singapore United Kingdom

References

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Codman in house testing reports, TR2213 and PVER99-133 Addendum

Reference Type BACKGROUND

Bayston R. Hydrocephalus Shunt Infections. Chapman and Hall Medical, London, 1989, p. 23.

Reference Type BACKGROUND

Bayston R, Grove N, Siegel J, Lawellin D, Barsham S. Prevention of hydrocephalus shunt catheter colonisation in vitro by impregnation with antimicrobials. J Neurol Neurosurg Psychiatry. 1989 May;52(5):605-9. doi: 10.1136/jnnp.52.5.605.

Reference Type BACKGROUND
PMID: 2732730 (View on PubMed)

Bayston R, Lambert E. Duration of protective activity of cerebrospinal fluid shunt catheters impregnated with antimicrobial agents to prevent bacterial catheter-related infection. J Neurosurg. 1997 Aug;87(2):247-51. doi: 10.3171/jns.1997.87.2.0247.

Reference Type BACKGROUND
PMID: 9254088 (View on PubMed)

Govender ST, Nathoo N, van Dellen JR. Evaluation of an antibiotic-impregnated shunt system for the treatment of hydrocephalus. J Neurosurg. 2003 Nov;99(5):831-9. doi: 10.3171/jns.2003.99.5.0831.

Reference Type BACKGROUND
PMID: 14609161 (View on PubMed)

Lozier AP, Sciacca RR, Romagnoli MF, Connolly ES Jr. Ventriculostomy-related infections: a critical review of the literature. Neurosurgery. 2002 Jul;51(1):170-81; discussion 181-2. doi: 10.1097/00006123-200207000-00024.

Reference Type BACKGROUND
PMID: 12182415 (View on PubMed)

Schierholz J, Jansen B, Jaenicke L, Pulverer G. In-vitro efficacy of an antibiotic releasing silicone ventricle catheter to prevent shunt infection. Biomaterials. 1994 Oct;15(12):996-1000. doi: 10.1016/0142-9612(94)90080-9.

Reference Type BACKGROUND
PMID: 7841297 (View on PubMed)

Zabramski JM, Whiting D, Darouiche RO, Horner TG, Olson J, Robertson C, Hamilton AJ. Efficacy of antimicrobial-impregnated external ventricular drain catheters: a prospective, randomized, controlled trial. J Neurosurg. 2003 Apr;98(4):725-30. doi: 10.3171/jns.2003.98.4.0725.

Reference Type BACKGROUND
PMID: 12691395 (View on PubMed)

Other Identifiers

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BAC-IN02-002

Identifier Type: -

Identifier Source: org_study_id